RESUMO
During the period from 1981 till 1989 87 resections for ulcerous injuries of particular severity were made in connection with the inflammation, destruction or spread of sclerosis in the pyloroduodenal zone. Measures of safety were complex and came to refusal from buried sutures in closing the duodenal stump, predominant use of Billroth-II resection in modifications foreseeing the creation of the Brown anastomosis (after Balfour, Roux), drainage of the abdominal cavity and actions for the liquidation of postoperative complications. Relaparotomy resulting from complications was necessary for 9 patients. One patient of 87 died.
Assuntos
Úlcera Duodenal/cirurgia , Duodeno/cirurgia , Gastrectomia/métodos , Complicações Pós-Operatórias/prevenção & controle , Antro Pilórico/cirurgia , Gastrectomia/efeitos adversos , Humanos , Lavagem Peritoneal , Cuidados Pós-Operatórios , Segurança , Índice de Gravidade de Doença , Técnicas de SuturaRESUMO
Results of using the open method of treatment of postoperative peritonitis in 26 patients are presented. Relaparotomy technique is described when "open abdomen" was used as a typical operation irrespective of causes of progressing peritonitis. In addition to surgical measures the authors stress the importance of intensive therapy. In relation with the character of postoperative peritonitis the abdominal cavity was closed by primary-delayed or secondary sutures on the 5-12th day. Lethality after using the open method of treatment of postoperative peritonitis was 30.7%.
Assuntos
Peritonite/cirurgia , Deiscência da Ferida Operatória/complicações , Adulto , Idoso , Drenagem/métodos , Feminino , Humanos , Peróxido de Hidrogênio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Nitrofurazona/administração & dosagem , Cuidados Pré-Operatórios , Reoperação , Técnicas de Sutura , Irrigação TerapêuticaRESUMO
Data on the surgical treatment of 954 patients are described, 613 of them being patients with complicated ulcers. Resection is considered to be indicated for gastric ulcers and for duodenal ulcers with pronounced hypersecretion, for atonia of the stomach and local changes hampering manipulations on the lesser omentum. Selective proximal vagotomy (SPV) was preferable in non-complicated duodenal ulcers, trunkal vagotomy was used as a forced measure in severe cases. The least postoperative lethality was noted after SPV (0,7%). Lethality after resections ranged from 1,3% to 2,2% depending on the method used.
